Hello all-
Does anyone have any research papers specifically proving no connection between suppressed TSH and osteoporosis. I have the @diogenes one about supressed TSH from exogenous hormone not causing hyperthyroidism but nothing specifically about osteoporosis......
Preempting and preparing for an imminent GP conversation!!
Thankyou
is there anything in the pinned posts, I think tattybogle had collated all the GP refubuffal arsenal . I can’t see it on my phone and am allotmenting.. can check on laptop later 🌱
thanks x I’ll look and see if I can find it
There's a couple in here: healthunlocked.com/thyroidu...
the first one:
is about "fractures", rather than osteoporosis ... it shows no increase in risk of fractures when TSH 0.04 -0.4 (in patients on levo) unfortunately it did show increased risk of fracture when TSH was below 0.04.. so depend how low your is whether that on is any use .
The second one:
is a link to a post from diogenes a couple of yrs ago: healthunlocked.com/thyroidu... longterm-subclinical-hyperthyroidism-does-not-affect-bone-density-in-patients-having-had-thyroid-ablation-for-cancer
he's talking about a long term study of pediatric patients who had TSH deliberately supressed as part of cancer follow up: "Bone Mineral Density in Adult Survivors of Pediatric Differentiated Thyroid Carcinoma: A Longitudinal Follow-Up Study " .... Published Online:10 Nov 2021
"Conclusions: This longitudinal study of pediatric DTC survivors demonstrated normal and stable median lumbar spine and femur BMD values after a median time of 17 and 23.5 years after diagnosis. However, compared with controls, a lower BMD was still found in 13.0% after prolonged follow-up despite intensive follow-up. Based on the studied follow-up period, these data do not provide convincing evidence in support of standard monitoring of bone mass among DTC survivors, but may be restricted to individual cases at low frequency".
....plus there's another one on that list which is related to T4 :T3 ratio and osteoporosis.. which i haven't yet looked at properly.
That’s brilliant Tatty - Thankyou for that
healthunlocked.com/thyroidu...
Does this help?
Posted by Diogenes some time ago.
Anecdotally, I was diagnosed with Osteoporosis several years ago when I had a normally functioning thyroid and before thyroidectomy for cancer necessitated suppressed TSH
thanks .. will look
There are many internet resources and research papers which debunk the theory that suppressed TSH causes osteoporosis.
just looked at it … PERFECT…. Thankyou x
You’re welcome
Hello Everywhere, are you still on a dose of levo that supresses your TSH? I had thyroid cancer in 1999 and had to take that dose (200µg), but not any longer since at least 16 years. Apparently the protocols have changed and a suppressive dose is no longer required in the follow-up of TC. (not that your TSH should rise too much). Best to you!
Hello ITHY
Thank you for your response.
Oncologist has explained that protocols no longer require TSH suppression. However, I take NDT and the T3 content leads to suppression anyway.
I’ve tried to raise my TSH and it’s simply not doable without reducing my dose to one which is not therapeutic / optimal.
Interestingly jimh111 posted a research paper some time ago which made the point, in technical language which I can’t recall, that once a TSH has been suppressed by thyroid meds it ‘remembers’ this and suppression is inevitable. Sorry I can’t be more scientific in my description - hope Jim can come along and explain as it’s fascinating.
With regard to Thyroid Cancer ‘protocols’ - it incenses me that these are changed with such impunity as ‘new research’ comes along. I had radioactive iodine as my tumour was very large and I was considered ‘at risk’. Not a day goes by without my regretting that I allowed them to give me this toxic substance and even signed a form to acknowledge my understanding of its potential long term effects. It’s now not used because of the evidence base which illustrates that long term effects are real and breathtakingly damaging. Too late now though.
TSH can remain suppressed for many months if it has been suppressed for some time by high hormone levels. Sometimes it does not recover. High hormone levels (usually reflected in a low TSH - IF the pituitary is working normally) can cause osteoporosis. However, most studies are misleading because they look at people with overactive thyroids and some of the subjects may have concurrent parathyroid damage. High hormone levels can also cause cardiac problems. Again doctors can be over zealous because an elevated TSH even with normal fT4 can be worse but they never mention this.
Generally, I would try and keep fT3 and fT4 around the middle of their intervals. Sometimes TSH will be low due to the pituitary underperforming, not because fT3 or fT4 are high.
Here are some notes I wrote on TSH remaining low healthunlocked.com/thyroidu... .
Aah. Thanks so much for the link.
I remembered that info so clearly - yet find it hard to recall what we had for lunch yesterday 😉
Everywhere /ITHY ..in technical language which I can’t recall, that once a TSH has been suppressed by thyroid meds it ‘remembers’ this
"Hysteresis"
~ explanation / papers..... starts at the end of the FIRST REPLY to this post : healthunlocked.com/thyroidu....
and continues in another reply much further down : healthunlocked.com/thyroidu... 
CONTINUED HYSTERESIS
Thank you 😊
Just an aside for word lovers:
Note that the ‘root’ of this word hysteresis is Greek for ‘behind/lagging’ but is not connected in any way with the root hyster which means womb. This particular etymology is found in hysterectomy and hysteria.
It’s a poor show that a word which conveys a display of wild and uncontrolled emotion is associated with a female body part.
Pft
Yes, the anger at the treatment. I too had RAI and a total thyroidectomy. Quality of life is far from optimal. It is better - if possible - to keep part of the thyroid. Probably because of RAI I had a relapse of another problem hyperPARAthyroidism. Big problem because I have only one parathryoid left and it should be excised because it is making my osteoporosis (-4.2) worse. But then you go from one disease (HYPERpara) to another (HYPOpara).
I understand. My PTH levels are also showing high at the moment. Investigation in progress.
Complicated business.
Good luck to you 😉
Many people who drink excessive amounts of alcohol have liver disease but not all people who have liver disease drink alcohol at all.
So many good analogies. Find a couple and batter your GP’s brains.
Don’t worry I will- I’m a scrapper!!
So far I’ve managed to totally circumvent any interaction with my GP as I’ve done it all privately … but now he wants to test me so want to be prepared !
I too have no contact with my GP re my NDT. It gets a bit thorny when you go into hospital. I just stand firm and don’t allow anyone to discuss thyroid issues with me.
Sounds like you can manage that 😉
Ha! Yes. 😋- I’ll be fine. Like to be totally prepared so can Instantly bat back any nonsense with educated reason and fact. Thankyou for your help
Good for you 🙂
Is this helpful? From the Thyroid UK website, Myths of Hypothyroidism, includes "The myth that a suppressed TSH leads to Osteoporosis" along with several others
thyroiduk.org/further-readi...
Keep fighting!
Some interesting stuff here. Like that it’s written in ‘plain English’ which most doctors would find easy to understand.
Thank you for posting
Thank you for the reminder. I've just reread this and I'm not sure if it's been updated since I last read it, but there's info there that I needed reminding of before disputing a reduction in dose.
Funny. Just this morning I was spending hours looking for answers to the same question. I read a publication by Thyroid Patients Canada, where I found that there is no conclusive research on the subject (still, the article made sense). And looking at different research publications I had already come to the same conclusion. If you want to read the article I read this morning here is the link: thyroidpatients.ca/?s=bone+... and here is another link (same source): thyroidpatients.ca/2018/07/... There was a study in 2014, I believe, which I can't find right now (but I'm sure somebody here has the link) that found no correlation between low TSH (0.04 and higher) and bone loss or artrial fibrillation. I think at this point it is not clear, until anybody decides to put some money into serious research (and does not look just at TSH but the whole thyroid hormone situation). But since there is most likely no money to be made from the results, there is no motivation to do such research (in my opinion anyway). Your best bet, if you want to take research to the doctor, is to find that one research, I mentioned above, from 2014. However, in my experience, doctors are not open to presented research. They do their own thing, which can vary from doctor to doctor. Good luck!
Thanks for the info
Hi I had the same battle a couple of years ago with GP I had never met - but felt well on the levothyroxine dose I was taking I looked at some research and am sure it was about a 1% risk If I remember right , so I said I accept the risk for osteoporosis and atrial fibrillation but the benefit to me being on this dose far outweighed me being on a lower dose that left me unable to function and get out of bed. I offered to put it in writing that I accept the risk and was ready to say if they felt they couldn’t manage me I would like to be referred to an endocrinologist. Finally GP said as long as your ft3 levels are ok it is not a problem ! I then got my ft3 checked by surgery for the first time always said they couldn’t check it !I assume as long as ft3 is ok on NDT the same applies !
Good luck 🤞
And that's the rub. Some wise member here pointed out that laying in bed all day because due to lack of energy barely being able to stand up will also raise the risk of osteoporosis (due to not "stressing" the bones). So its better to feel well and take the risk than not feeling well and having the risk anyway.
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